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Prognostic Significance of Immune and Stromal Components in Colorectal Cancer: Practical Tools for Routine Pathologic Assessment

  • 0From the Department of Pathology, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea (Jang, Kim).
Archives of Pathology & Laboratory Medicine +

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March 20, 2025

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March 20, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Evaluating the tumor microenvironment in colorectal cancer (CRC) using routine pathology methods like tumor to stroma ratio (TSR) and Crohn-like lymphoid reaction (CLR) can predict patient survival. This approach offers significant prognostic value for CRC.

Area Of Science

  • Oncology
  • Pathology
  • Cancer Research

Background

  • The tumor microenvironment in colorectal cancer (CRC) comprises cancer-associated fibroblasts and immune cells, influencing patient prognosis.
  • Understanding the prognostic significance of these elements is crucial for effective CRC management.

Purpose Of The Study

  • To assess the tumor microenvironment in CRC using practical methods suitable for routine pathology.
  • To identify prognostic factors within the tumor microenvironment for disease-specific and progression-free survival.

Main Methods

  • A comprehensive analysis of local immune response and tumor to stroma ratio (TSR) was conducted on 930 CRC cases using hematoxylin-eosin (H&E) slides.
  • Immune responses were evaluated via peritumoral inflammatory infiltration, intratumoral stromal tumor-infiltrating lymphocytes (TILs), and Crohn-like lymphoid reaction (CLR).

Main Results

  • Multivariate analysis identified age, advanced stage, microsatellite stability, specific tumor subtypes, extramural venous invasion, high TSR, and CLR as independent prognostic factors for disease-specific survival.
  • These factors, excluding microsatellite stability, also predicted progression-free survival.
  • Assessing stromal TILs within the deepest intratumoral stroma emerged as an independent predictor of progression-free survival.

Conclusions

  • Evaluating Crohn-like lymphoid reaction (CLR), tumor to stroma ratio (TSR), and stromal tumor-infiltrating lymphocytes (TILs) on H&E-stained slides is a practical and effective method.
  • This approach provides significant prognostic value for colorectal cancer patients.